Late-preterm infants, early-term infants, and timing of elective deliveries; current status in a Korean medical center

J Matern Fetal Neonatal Med. 2019 Apr;32(8):1267-1274. doi: 10.1080/14767058.2017.1404564. Epub 2017 Nov 22.

Abstract

Objective: The aim of this study was to examine the current perinatal outcomes among infants born late-preterm and early-term compared to those born full-term and evaluate the optimal gestational age for delivery.

Methods: We performed a retrospective cohort study for births occurred at Seoul St. Mary's Hospital over the past 7 years. Statistical comparison was performed using χ2 test and multivariable logistic regression models.

Results: A total of 7580 women met the study criteria. Compared to 39 weeks, delivery at late-preterm and early-term had higher risk of composite morbidity, including respiratory morbidities, intracranial hemorrhage (ICH), and admission to neonatal intensive care unit (NICU) (34 weeks adjusted odds ratio [aOR]: 132.54; 95% confidence interval (CI): 74.00-240.10; 37 weeks aOR: 2.14; 95%CI: 1.65-2.77). The risks of sepsis and necrotizing enterocolitis in deliveries before 36 weeks and the risk of feeding difficulty in deliveries before 37 weeks were significantly higher than those of 39 weeks. Neonatal morbidity at deliveries was not significantly different between 38 and 39 weeks.

Conclusions: Neonatal morbidities at late-preterm births are significant and surveillance for them seems increasing. Obstetricians should recognize the risk of respiratory morbidity, ICH, and NICU admission for deliveries before 38 weeks' gestation.

Keywords: Delivery; early-term; late-preterm; morbidity; outcome.

MeSH terms

  • Adult
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / epidemiology*
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Premature Birth / classification*
  • Premature Birth / epidemiology
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors
  • Term Birth*